Individual
DR. JUSTIN KENNETH BROOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2015-02465
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2014
Last updated
03/07/2018
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